Ultrasound biomicroscopic imaging in paediatric ocular toxocariasis

Liu, Jinghua; Li, Songfeng; Deng, Guangda; Yang, Wenli; Chen, Wei; Lü, Hai

doi:10.1136/bjophthalmol-2016-309850

Cited by 13 publications

(7 citation statements)

References 22 publications

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“…UBM identified 95% of peripheral granulomas compared to intraoperative evaluation [31]. Compared with indirect ophthalmoscope, statistical analysis showed significant differences in the number of clock hours of peripheral pathology detected by UBM [32]. In summary, all toxocariasis studies found UBM to improve the detection rate of peripheral granulomas, which were more common than posterior granulomas.…”

Section: Uveitismentioning

confidence: 88%

A systematic review of ultrasound biomicroscopy use in pediatric ophthalmology

Alexander

Wei

Palmer

et al. 2020

Eye

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Ultrasound biomicroscopy (UBM) is the only available option for noninvasive, high-resolution imaging of the intricate iridociliary complex, and for anterior segment imaging with corneal haze or opacity. While these unique features render UBM essential for specific types of trauma, congenital anomalies, and anterior segment tumors, UBM imaging has found clinical utility in a broad spectrum of diseases for structural assessments not limited to the anterior intraocular anatomy, but also for eyelid and orbit anatomy. This imaging tool has a very specific niche in the pediatric population where anterior segment disease can be accompanied by corneal opacity or clouding, and anomalies posterior to the iris may be present. Pediatric patients present additional diagnostic challenges. They are often unable to offer detailed histories or fully cooperate with examination, thus amplifying the need for high-resolution imaging. This purpose of this systematic review is to identify and synthesize the body of literature involving use of UBM to describe, evaluate, diagnose, or optimize treatment of pediatric ocular disease. The collated peer-reviewed research details the utility of this imaging modality, clarifies the structures and diseases most relevant for this tool, and describes quantitative and qualitative features of UBM imaging among pediatric subjects. This summary will include information about the specific applications available to enhance clinical care for pediatric eye disease.

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Section: Uveitismentioning

confidence: 88%

A systematic review of ultrasound biomicroscopy use in pediatric ophthalmology

Alexander

Wei

Palmer

et al. 2020

Eye

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“…Compared to conventional ultrasound or color Doppler imaging (CDI), UBM has higher spatial resolution and is suitable for detailed examination of the anterior segment. The value of indirect ophthalmoscopy is limited due to the blurring of anterior segment structures caused by the turbidity of the refractive media in the anterior segment and peripheral retina ( 25 ). UBM has certain value in the diagnosis and differential diagnosis of peripheral granulomatous OT.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, UBM helps in observing complications involving the peripheral retinochoroidal structures in OT patients, such as ciliary detachment ( 27 , 28 ). Prior to surgery, UBM examination can assist surgeons in selecting appropriate PPV incision sites, avoiding contact with peripheral granulomas and preventing granuloma perforation-induced retinal break or retinal detachment ( 25 ). Therefore, UBM holds significant value in the diagnostic assessment and surgical guidance of peripheral granulomatous OT in children.…”

Section: Introductionmentioning

confidence: 99%

Case report: Ultrasound biomicroscopy as a guide for the selection of injection sites for dexamethasone intravitreal implant (Ozurdex) for peripheral granulomatous ocular toxocariasis in children

et al. 2023

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PurposeThis article aims to report a case of successful treatment of peripheral granulomatous ocular toxocariasis (OT) in an 8-year-old patient using intravitreal injection of dexamethasone (DEX) implant (Ozurdex) under ultrasound biomicroscopy (UBM) guidance.Case presentationA previously healthy 8-year-old boy with a history of long-term close contact with dogs complained of blurring of vision in the right eye for a year. Ophthalmic examination of his right eye showed chronic uveitis. Notably, UBM examination identified granulomas and peripheral vitreous strand in the ciliary body from 3 to 8 o'clock positions. Enzyme-linked immunosorbent assay (ELISA) results of the intraocular fluid (IF) and serum showed increased anti-Toxocara immunoglobulin G (IgG) levels, leading to a diagnosis of peripheral granulomatous OT in the right eye. Intraocular surgery was not indicated in this case. The treatment goal was to alleviate uveitis, improve visual acuity, and prevent complications. He was treated with an intravitreal injection of DEX implant, administered as a single dose every three months, total two doses, combined with albendazole, an oral anthelmintic. Under preoperative UBM guidance, two injections were performed at the 12 and 10 o'clock positions in the pars plana where there were no granulomas and peripheral vitreous strand, successfully preventing complications associated with intravitreal injection. After two injections, the patient's right eye vision improved significantly, with the best-corrected visual acuity (BCVA) increasing from 20/400 to 20/50. Vitreous opacity and retinal edema were reduced, preretinal proliferative membrane was stabilized, and no adverse events occurred.ConclusionUBM can accurately determine the location and extent of peripheral granulomas in OT patients, facilitating the avoidance of granulomas during intravitreal injection and preventing complications associated with intravitreal injection. Under the close follow-up and strict adherence to indications, preoperative UBM-guided intravitreal injections of DEX implant treatment for pediatric peripheral granulomatous OT are safe and effective, providing a new therapeutic option for pediatric peripheral granulomatous OT.

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“…B-scan ultrasonography uses the reflections of highfrequency sound waves to construct a two-dimensional, cross-sectional view of the tissue. In toxocariasis, ultrasonography can be utilized to reveal the optic disc granuloma, vitreous bands, retinal folds, and tractional retinal detachment, and also, it is useful in ruling out the presence of ocular tumor (Liu et al 2017).…”

Section: Diagnostic Imaging Techniquesmentioning

confidence: 99%

Ocular toxocariasis: a neglected parasitic disease in Egypt

El-Sayed

Masoud

2019

Bull Natl Res Cent

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Background: Ocular toxocariasis is considered a parasitic disease of major socioeconomic importance. In spite of the high prevalence of human toxocariasis (up to 84%) among Egyptian patients, the incidence of ocular toxocariasis is underestimated. The recognition of this neglected disease would be the initial step to overcome it. Thus, this review gave updated information on the pathogenesis, clinical manifestations, diagnosis, and treatment of ocular toxocariasis. Results: Ocular toxocariasis is an important cause of unilateral vision impairment mostly in children and always in the differential diagnosis of retinoblastoma. This disease exhibits various manifestations such as posterior pole granuloma, peripheral granuloma, or chronic endophthalmitis. Diagnosis of ocular toxocariasis can be carried out by the ophthalmic examination and immunodiagnostic methods to reveal the specific antibodies in serum and ocular fluids. In addition, molecular diagnosis, medical imaging techniques, and histopathologic observation of Toxocara larva in the surgically obtained specimens can be performed. Ocular toxocariasis can be treated either medically or surgically. Regarding medical treatment, the ophthalmologists prefer to use steroids and anthelminthic drugs; however, there are no standardized parameters for doses, duration, and route of administration. Conclusion: Clinical suspicion plays a leading role in the diagnosis of ocular toxocariasis, but always with other diagnostic methods. Accurate diagnosis and prompt treatment can minimize ocular morbidity.

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Ultrasound biomicroscopic imaging in paediatric ocular toxocariasis

Abstract: UBM seems to be a valuable and reliable diagnostic technique for the evaluation of patients with ocular toxocariasis. Longitudinal studies will have to determine the relevance of UBM findings for the individual clinical course and their influence on therapeutic decisions.

Cited by 13 publications

References 22 publications

A systematic review of ultrasound biomicroscopy use in pediatric ophthalmology

A systematic review of ultrasound biomicroscopy use in pediatric ophthalmology

Case report: Ultrasound biomicroscopy as a guide for the selection of injection sites for dexamethasone intravitreal implant (Ozurdex) for peripheral granulomatous ocular toxocariasis in children

Ocular toxocariasis: a neglected parasitic disease in Egypt

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